Provider Demographics
NPI:1508666579
Name:GRACELAND HOME HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:GRACELAND HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DICKSON
Authorized Official - Middle Name:
Authorized Official - Last Name:APPIAH-BAAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-596-2774
Mailing Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3312
Mailing Address - Country:US
Mailing Address - Phone:614-596-2774
Mailing Address - Fax:
Practice Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3312
Practice Address - Country:US
Practice Address - Phone:614-596-2774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty